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Kunihiro Azuma, Shuichiro Eguchi, Takashi Ueta; With or without internal limiting membrane peeling during vitrectomy for epiretinal membrane: A systematic review of literature and meta-analysis. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1057.
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© ARVO (1962-2015); The Authors (2016-present)
Additional internal limiting membrane (ILM) peeling in vitrectomy for epiretinal membrane (ERM) is a widely accepted surgical procedure, but its beneficial effects have still been controversial. Thus, we conducted a systematic review of literature and meta-analysis to summarize the current evidence on the effects of ILM peeling in vitrectomy for ERM.
Medline, CENTRAL, and Embase were systematically reviewed. The terms used for the systematic search were “epiretinal membrane,” “fibrovascular membrane,” “pucker,” “internal limiting membrane,” and “inner limiting membrane.” Eligible studies included randomized or nonrandomized studies that compared surgical outcomes of vitrectomy with or without ILM peeling for idiopathic ERM. Outcome measures were best-corrected visual acuity (BCVA), central macular thickness (CMT), and ERM recurrence. The longest postoperative data were used to analysis.
Twelve studies that included 2029 eyes were selected. Among 12 studies, two studies were prospective studies, and the others were retrospective comparative studies. There are no randomized controlled studies in this current meta-analysis. The duration of follow-up was from 6 to 18 months. There was no significant difference in preoperative BCVA (mean difference (MD) 0.02 logMAR; 95%CI −0.03 to 0.06) and CMT (MD 6.63µm; 95%CI −15.89 to 29.15; P = 0.82). There was no significant difference in postoperative BCVA (MD 0.01 logMAR; 95%CI −0.05 to 0.08) and CMT (MD 13.38; 95%CI −13.55 to 40.31). The ERM recurrence rate was significantly lower with ILM peeling than without ILM peeling (Odds ratio 0.26; 95%CI 0.12 to 0.54).
Additional ILM peeling in vitrectomy for idiopathic ERM could contribute to the lower recurrence rate of ERM, while it does not significantly influence BCVA and CMT.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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